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A 15 year old African immigrant is referred after a murmur was detected during a routine medical examination. He appears to be asymptomatic.

His birth and medical histories are unremarkable. There is no history of rheumatic fever.

Select Relevant Investigations
ECG

Performed

The ECG appears normal.
Chest X-Ray

Performed

The X-Ray appears normal.
Echocardiogram

Performed

Echocardiography shows a small perimembranous VSD, with minimal left to right shunting. No other structural cardiac defects are present and pulmonary vascular pressures are normal. The pulmonary to systemic blood flow ratio is 1.1:1
Coronary Angiogram

Performed

The coronary angiogram shows a left dominant coronary vasculature and is otherwise normal.

Select Relevant Management
Endocarditis Prophylaxis
Antiarrythmic therapy
Surgical closure
Cardiac Transplantation